Archived: Dr J & Colleagues

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective- this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.At our last assessment we rated this key question Good. At this assessment the rating has remainedGood: This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people's care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs. However, people told us they were not always involved in the planning and reviewing of their care. We also saw care plan audits which showed that people did not sign their care plans, acknowledging that they have been actively involved in the development of the care plan and that they are happy with the information and actions included.

There was evidence that staff provided a range of care and treatment interventions suitable for the service. The interventions were delivered in line with guidance from the National Institute for Health and Care Excellence (NICE). Staff ensured that people had good access to physical healthcare, including access to specialists when needed. Staff were experienced and up-to-date with current research and evidence in ADHD and ASD.

However, there was evidence that not all staff delivered people's care and treatment in line with national guidance. For example, our review of care records found a lack of continuity across the clinical team. There was no standardised report template to structure ADHD assessments. This meant some reports lacked a comprehensive psychosocial assessment and developmental and psychiatric history. There was also limited evidence that clinical audit, benchmarking and quality improvement initiatives were fully embedded.

However, leaders told us that they were fully committed to addressing the inconsistencies and making improvements by developing a formal auditing programme across the service.

The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when they moved between different services. The service held regular team meetings where they shared information. The administration and booking team held a daily morning meeting to discuss queries. Psychiatrists and non-medical prescribers held monthly meetings to discuss clinical cases and provide training and peer support. Leaders worked with system partners and held quarterly meetings with the integrated care board (ICB). However, there was limited evidence that multidisciplinary team meetings took place on a regular basis, and staff told us that teams across the service often worked in isolation.

The service supported people to manage their health and wellbeing so they can maximise their independence, choice and control, live healthier lives and where possible, reduce their future needs for care and support. People said they felt empowered and supported by the service following their assessments and that they were encouraged to make healthier choices to help promote and maintain their health and wellbeing. Medication was only prescribed to people once all physical healthcare checks were completed and the service had access to a cardiologist to oversee complex cases.

The provider routinely monitored people’s care and treatment to continuously improve it and to ensure that outcomes are positive and consistent, and that they meet both clinical expectations and the expectations of people themselves. Feedback was collected after every assessment and leaders held regular meetings with local stakeholders, including the ICB who monitored clinical outcomes at quarterly meetings.

The provider did not always tell people about their rights around consent. Our care records review found that in one case a mother had given consent on behalf of her 17-year-old child. We did not see any evidence that the child's views had been taken into consideration. We also found that the child and adolescent consent form did not have an option for over 16's to provide consent. This meant that their ability to consent was not taken into account. However, the consent form for adults was in line with NICE guidance and staff assessed and recorded capacity to consent appropriately.